Hepatitis C infection
Since hepatitis C virus was first discovered in the late 1980s, thousands of Australians have been found to be infected with this virus. In Australia, almost 300,000 individuals have been exposed to the hepatitis C virus, and more than 200,000 of these are living with chronic (ongoing) hepatitis C. Around 10,000 new infections are detected each year.
Hepatitis C transmission
The virus is usually transmitted through blood-to-blood contact. Before 1990 it was possible to catch hepatitis C in Australia through an infected blood transfusion. However, now that all blood in this country is screened for the virus, most new cases of hepatitis C are caused by the sharing of contaminated needles by injecting drug users.
Other ways hepatitis C virus is spread include through tattooing and body piercing with unclean equipment, unsterile medical procedures and injections such as vaccinations (e.g. in developing countries) and 'needlestick injuries' (for doctors, nurses and other health care workers). Infected mothers can pass the virus on to their unborn children. It is possible, but uncommon, to catch the disease by using a razor or toothbrush that has been contaminated with the blood of an infected person. Sexual transmission of the virus is very unlikely unless there is blood-to-blood contact.
There is as yet no vaccine against hepatitis C.
Hepatitis C symptoms
In the short-term, infection with hepatitis C virus often causes no symptoms or a mild illness that may feel like flu. Around 20–30 per cent of people who are infected will clear the hepatitis C virus and appear to completely recover from the disease, but three-quarters will develop chronic infection. Chronic infection may have no symptoms, especially at first, but over years may damage the liver and cause symptoms such as fatigue, nausea, muscle aches or abdominal discomfort.
Hepatitis C treatment
Treatment of hepatitis C has improved dramatically in recent years. Currently, pegylated interferon plus ribavirin for 6 to 12 months has become standard treatment for hepatitis C in Australia. A single weekly injection of pegylated interferon treatment has been shown to be more effective and associated with fewer side effects than the original interferon treatments. Combination therapy is successful in clearing the hepatitis C virus from the body in 50 to 80 per cent of people who finish treatment. The cure rate depends partly on which type (genotype) of hepatitis C virus you are infected with. There are several newer treatments currently being tested around Australia, but these are not generally available as yet.
The decision to treat hepatitis C with antiviral therapy depends on a number of factors, including whether you have active hepatitis C (tests show the virus is present in your blood), how long you have had the infection, the extent of the liver damage, whether you have symptoms, whether you have other illnesses, and whether you wish to be treated.
Chronic hepatitis C infection
Without treatment, around half of people with chronic hepatitis C will develop symptoms and liver damage, usually over a period of about 20 years. Ten to 20 per cent will develop cirrhosis. The risk of developing cirrhosis is increased by a number of factors, including whether you drink alcohol, are obese, have diabetes, and are also infected with hepatitis B virus or HIV. Some of those with cirrhosis will also develop liver failure or a form of liver cancer known as hepatocellular carcinoma.
Hepatitis C is currently the most common reason for liver transplant in Western countries, and it is one of the most common causes of liver cancer in Australia.
Hepatitis C is an area of intensive research. In the future it is expected that testing for the disease will become more sensitive and specific, new therapies will be developed and more treatment centres will become available. It is also hoped that programmes such as the needle exchange program will continue to reduce the rate of new cases of the infection in Australia.
Last Reviewed: 07 July 2010
- 1. Hepatitis Australia. Hepatitis C. http://www.hepatitisaustralia.com/about-hepatitis/hepatitis-c (accessed Jan 2011).
2. Hepatitis Australia. Hepatitis C. Transmission. http://www.hepatitisaustralia.com/about-hepatitis/hepatitis-c/transmission (accessed Jan 2011).
3. Hepatitis Australia. Hepatitis C. Medical treatments. http://www.hepatitisaustralia.com/about-hepatitis/hepatitis-c/medical-treatments (accessed Jan 2011).
4. Chronic hepatitis C (revised Sep 2006). In: eTG complete (Internet). Melbourne: Therapeutic Guidelines Limited; Nov 2010. http://online.tg.org.au/complete/ (accessed Jan 2011).
5. MayoClinic.com. Hepatitis C (published 12 Sep 2009). http://www.mayoclinic.com/health/hepatitis-c/DS00097 (accessed Jan 2011).
6. Hepatitis C Council of NSW. Hep C factsheets. Heps A, B & C (last reviewed May 2009). http://www.hep.org.au/documents/factsheets/HepsABC-220KB.pdf (accessed Jan 2011).
7. Australian Government Department of Health and Ageing. National hepatitis C resource manual. 2nd ed.Canberra: The Department; 2008. http://www.health.gov.au/internet/main/publishing.nsf/content/phd-hepc-manual-2008 (accessed Jan 2011).
8. Ghany MG, Strader DB, Thomas DL, Seeff LB, American Association for the Study of Liver Diseases. Diagnosis, management, and treatment of hepatitis C: an update. Hepatology 2009; 49: 1335-74. http://onlinelibrary.wiley.com/doi/10.1002/hep.22759/full (accessed Jan 2011).
